Inter-Rater Reliability of the Tracking and Reporting Outcomes of Procedural Sedation Tool

Clinical guidelines recommend that procedural sedation outcomes should be audited. The Tracking and Reporting Outcomes of Procedural Sedation (TROOPS) tool, developed by the International Consortium for the Advancement of Procedural Sedation, is intended to be suitable for use in all locations by sedation providers. We evaluated the feasibility and reliability of using a modified version of the TROOPS tool for sedation that is administered by nurses in the cardiac catheterization laboratory. The version of TROOPS we used contained items in the minor, intermediate, and sentinel categories. Two nurses independently completed the TROOPS tool for 40 patients who underwent a procedure with sedation. A sedation-related adverse event was selected by at least one of the raters for 21 of the patients (52%; 95% confidence interval [CI] = 0.38 to 0.67). Most were minor events related to the airway and breathing category of the TROOPS tool (n = 17; 42%; 95% CI = 0.29 to 0.58). The remaining were intermediate-severity events related to sedation quality. No events for the other categories of the TROOPS tool were selected. The intraclass correlation coefficient between paired nurse ratings of the TROOPS tool was 0.78 (95% CI = 0.43 to 0.92). Most nurses (85%, 95% CI = 73% to 92%) reported that it took less than 1 minute to complete the tool. In summary, paired ratings of sedation-related adverse events by nurses achieved moderate consistency using a modified version of the TROOPS tool containing items from the minor category of the airway and breathing domain. Use of this tool in clinical practice is feasible and reliable.